Beware of colon cleansing claims

To read the Internet ads, you'd think that our bodies were awash in "toxins" -- usually unspecified -- and that we should therefore go to dramatic lengths, such as "colon cleansing" and chelation, to get rid of all this bad stuff.

Don't believe it. Or to put it more gently, don't risk your health or your pocketbook on programs that promise to "detoxify" you -- not without doing your homework first. For starters, ask exactly what these supposed "toxins" are. And think twice -- or 20 times -- before undergoing chelation, a procedure that uses powerful drugs to rid your body of heavy metals, such as mercury and lead.

Some alternative medicine practitioners, such as Dr. Glenn Rothfeld, medical director of WholeHealth New England in Arlington, Mass., believe that cleaning out the colon occasionally may help some people, particularly those with irritable bowel syndrome, "though whether it helps by getting rid of toxins is not clear."

And there's some evidence, Rothfeld said, that the digestive tracts of people who eat typical Western diets may move wastes along more slowly than those of people who eat more fiber. In theory, this longer "transit time" could mean that some substances, like nitrosamines, which are found in preserved meats and are carcinogenic in animals, have more time to cause trouble.

But, generally, people don't need to take dramatic steps to "detoxify" themselves because human bodies have multiple systems for getting rid of wastes: by sweating, exhaling, urinating and defecating. If you really want a "clean" system, eat more fruits and vegetables and less junk food, all of which we're supposed to do anyway.

One testimonial ad, next to a truly gross picture on www.drnatura.com, reads, "How would you feel if long pieces of old toxin-filled fecal matter were stuck to the inside of your colon for months or even years?" But it's simply not true that waste material gets stuck indefinitely in the colon -- though the cleansing products themselves can form the gels that look like huge stools.

"I've heard my kids say that there's stuff in the GI [gastrointestinal] tract for seven years," said Dr. Douglas Pleskow, a gastroenterologist at Beth Israel Deaconess Medical Center. "That is the urban legend. In reality, most people clear their GI tract within three days."

Fuzzy science

The ads for colon cleansing are also remarkably vague about what toxins would be purged with enemas, laxatives or special diets. Author Peter Glickman advocates a raw food diet. Asked what toxins his colon-cleansing dietary regimen "Master Cleanse" gets rid of, Glickman named "metabolic toxins," parasites and "environmental toxins . . . whatever kinds of stuff we're breathing in air."

Wrong, said Dr. Bennett Roth, a gastroenterologist at UCLA. "There is absolutely no science to this whatsoever. There is no such thing as getting rid of quote-unquote 'toxins.' The colon was made to carry stool. This is total baloney."

The content of the intestinal tract is mostly bacteria, which can aid digestion. "An enema or laxative does not get rid of more 'bad' versus 'good' bacteria," said Dr. David Heber, director of the UCLA Center for Human Nutrition. It gets rid of both. "We don't like the idea of carrying bacteria, so lots of folks want to cleanse. But remember, bacteria can be your friend."

Moreover, colon cleansing would do no good for environmental pollutants such as PCBs and DDT, which are stored not in the gut but in fat, and therefore can't be eliminated by colon cleansing, said Dr. Ed Zimney, medical director of Healthtalk.com, a website dedicated to chronic diseases.

(Disclaimer: The writer is the host of a weekly radio show on Healthtalk.com.)

Perhaps most worrisome, colon cleansing can actually be dangerous, because most techniques draw fluid from surrounding tissues into the colon. This disrupts the balance of electrolytes such as sodium, potassium, chloride, calcium, magnesium and phosphorus, said Pleskow of Beth Israel. This shift in fluids can lead to dehydration and low blood pressure.

As for chelation, it can be useful to get rid of heavy metals such as lead in people with very high levels in their blood. But chelation can also be dangerous: The chelating drugs can be toxic to the liver and kidneys.

It is inappropriate for people who have near-normal levels of heavy metals to get chelation therapy, said Dr. Rose Goldman, an associate professor of environmental health at the Harvard School of Public Health.

Beware of practitioners who use hair samplings to detect multiple heavy metals and elements, Goldman said. "This type of hair sampling is highly inaccurate," she said. Some practitioners push chelation on people who complain of vague symptoms like fatigue and difficulty concentrating, which could easily be due to problems other than heavy metal poisoning.

Be informed

If you decide on chelation, ask if the physician is board certified by the Accreditation Council for Graduate Medical Education or the American College of Occupational and Environmental Medicine. Be skeptical about practitioners who say they practice "clinical ecology," which is not a recognized medical specialty.

And before you jump to chelation, said Dr. Alan Woolf, director of the pediatric environmental health center at Children's Hospital Boston, make sure the environment is as free as possible of the contaminant in question, such as lead, so you don't recontaminate yourself. And try conservative treatments first, such as adding calcium, zinc and iron to the diet because these minerals can block the body's absorption of lead.

Before you fall prey to the country's rampant toxic phobia, take a moment to ponder the whole notion of detoxification. And remember, your body has an extraordinary ability to cleanse itself.